Objective To investigate the clinical characteristics and risk factors of lower respiratory tract infection of adults in rural community.Methods Totally 298 adult patients aged 18 years old and above with lower respiratory tract infection admitted to our hospital from January 2016 to December 2017 were selected as the infection group, and 300 non-respiratory tract infection patients in the same period were selected as the non-infection group. The clinical data, clinical characteristics and inflammation indicators were retrospectively reviewed, including fever, cough, expectoration, shortness of breath, blood routine, CRP and hospitalization days. Multifactor regression analysis was used to study the risk factors of lower respiratory tract infection.Results The main clinical features and constituent ratios of 298 adult patients with lower respiratory tract infection in community were cough (98.66%), sputum (88.93%), shortness of breath (55.70%) and fever (12.75%). Blood routine examination showed that white blood cells were normal (62.08%), increased (19.46%), decreased (7.05%), neutrophils increased (21.48%), decreased (10.40%), lymphocyte increased (4.36%), decreased (5.37%). CRP was normal (58.73%), increased (26.17%), decreased (15.10%). The average length of stay was 8.65 plus 1.25 days. Multivariate logistic regression analysis showed that lower respiratory tract infection was closely related to autumn and winter (OR=1.940，95%CI：1.364～2.757) and chronic respiratory diseases (OR=11.035，95%CI： 6.098～19.970) (P<0.05).Conclusion There are many clinical characteristics and risk factors of respiratory tract infection in rural adult community. Effective interventions should betaken to reduce the infection rate and improve the quality of life of patients.
Objective To investigate the streptococcus B infection in women with premature rupture of term membranes and the effect of vaginal microbiome disorders on maternal and infant outcomes, and to provide basis for clinical treatment and prevention.Methods Eightyfour pregnant women with premature rupture of membranes admitted to our hospital from January 2017 to December 2018 were selected as the research group, and 84 cases of pregnant women without premature rupture of membranes at full term were selected as the control group during the same period. The streptococcus B carriers and vaginal microflora in the lower reproductive tract of the two groups of pregnant women were observed and compared, and their effects on maternal and infant outcomes were summarized.Results The rate of group B streptococcus in the pregnant women in the study group was 19.05%, the proportion of pregnant women′s vaginal PH value > 4.5 was 60.71%, and the incidence rate of vaginal microflora disorder was 84.52%, which were all higher than those of the control group (3.57%, 35.71%, 55.95%), and the difference was statistically significant (χ2=8.924, 12.037, and 18.271, P<0.05). However, there was no statistically significant difference between the two groups in terms of bacterial vaginitis, candida vulvovaginitis and vaginal cleanliness (P>0.05). The infection rate of group B streptococcus positive was 31.25%, the incidence of chorioamnionitis was 31.25%, the incidence of fetal distress was 37.50%, and the incidence of neonatal pneumonia was 31.25%, higher than those of group B streptococcus negative 7.35%, 7.35%, 7.35%, and 4.41%, so there was statistically significant difference (χ2=8.366,11.177, 12.215, 8.333, P<0.05). There was no significant difference in the incidence of puerperal infection rate, chorionic amnionitis, fetal distress and neonatal pneumonia between the pregnant women with microbiome disorder and the normal ones (P>0.05). Conclusion Group B streptococcus bacteria in pregnant women with premature rupture of term membranes had a negative effect on maternal and infant outcomes, while the disorder of vaginal microflora had no significant effect on maternal and infant outcomes. Therefore, clinical attention should be paid to the situation of group B streptococcus bacteria in pregnant women.
Objective By analyzing the disease composition of 3 074 inpatients in the Children's Development Behavior Center in a hospital from 2014 to 2018, we can make people know more about children's growth retardation and developmental disorders, and provide basis for clinical research and disease prevention in the hospital.Methods Excel was used to analyze the medical records of inpatients in the Children's Development Behavior Center of our hospital in the past five years.Results The ratio of male to female children was 6.25 :1. Children with autism accounted for 88.81%, followed by mental retardation（4.46%）, language development disorder（1.11%）. The rank and composition of psychological problems in children of different age groups were different. Conclusion The number of outpatients in children's psychological clinics is increasing year by year, and the characteristics of children's psychological and behavioral problems are different in different age groups. Hospitals and governments at all levels should strengthen the construction of children's developmental behavior centers and train more experts with the ability to diagnose and treat children's developmental retardation and developmental disorders, especially to improve the diagnosis and treatment of children's autism.
Objective To analyze the risk factors of intravenous infusion in outpatients of a tertiary children′s hospital, and to explore related preventive interventions.Methods From June 2017 to October 2018, 486 children who received intravenous infusion treatment in the infusion room of the tertiary children′s hospital were retrospectively analyzed. Retrospective analysis was carried out on the basic data of the children, the incidence rate of transfusion reaction in the course of intravenous infusion was recorded, and the risk factors of transfusion reaction were discussed.Results In 486 cases, 44 cases of infusion reaction occurred during the infusion, and the incidence rate was 9.1%. Multivariate logistic regression analysis showed that children under 7 years old (OR=1.991), infusion volume over 1 000 ml (OR=1.415), low immune function (OR=4.158), pyrogenic source (OR=1.960), drug irritation strong (OR=1.914), past history of allergic disease (OR=5.778), drug deterioration (OR=1.451), particulate contamination (OR=1.765), and infusion speed too fast (OR=1.634) were risk factors for outpatient intravenous infusion reactions. The difference was statistically significant (P<0.05).Conclusion The hospital needs to strengthen the health education of the medical staff on the infusion reaction, strictly grasp the precautions and indications of intravenous infusion, and master the treatment methods of infusion reaction to reduce the occurrence of infusion reaction.
Objective To study the distribution of pathogenic bacteria in wounds of traumatic fractures and related drug resistance, in order to provide guidance for the rational application of antibacterial drugs.Methods Totally 3 154 patients with traumatic fracture complicated with wound infection treated in our hospital from July 2017 to October 2018 were observed in this study.The general data of the patients were collected, and the distribution and drug resistance of pathogenic bacteria in the wounds of infected wounds were analyzed.Results A total of 3 154 pathogenic bacteria were isolated from infected wounds in 3154cases with traumatic fractures.Among them, 2 129 cases of strains (67.5%) were detected gram-positive bacteria, mainly staphylococcus aureus and staphylococcus epidermidis, and 984 cases of strains (31.2%) were detected gramnegative bacteria, mainly Escherichia coli and Enterobacter cloacae. The Staphylococcus aureus and Staphylococcus epidermidis were highly sensitive to linezolid, ampicillin, tigecycline and nitrofurantoin, and the drug resistance rate was 0.0%. And Staphylococcus epidermidis was highly sensitive to ciprofloxacin, and the drug resistance rate was 0.0%. However, the resistance rate of Staphylococcus aureus and Staphylococcus epidermidis to penicillin was 100%. At the same time, the resistance rates of Staphylococcus aureus and Staphylococcus epidermidis to other antibiotics were under 50%. Escherichia coli resistance to cefazolin, ampicillin, sulbactam, ceftriaxone, extendedspectrum β-lactamase, levofloxacin was over 70%, but for erythromycin and imipenem, Piperacillin, amikacin, ertapenem it was non-resistant. Enterobacter cloacae was not resistant to imipenem, but the resistance rate to other 15 antibacterial drugs was over 20%.Conclusion The distribution of pathogenic bacteria in wounds of traumatic fractures is mainly gram-positive bacteria such as Staphylococcus aureus and Staphylococcus epidermidis. The clinical treatment needs to select antibiotics according to the results of drug resistance analysis to avoid the outbreak of infection.
Objective To discuss influence factors of postpartum pelvic floor dysfunction.Methods One hundred postpartum parturients were selected from July 2015 to July 2018 in our hospital. The clinical data were collected and the pelvic floor function was examined with routine gynecological examination. The influence factors of postpartum pelvic floor dysfunction were analyzed.Results Among the 100 postpartum parturients, 23 cases had pelvic floor dysfunction, and the incidence was 23.00%. Chi-square test results showed that age, parity, weight gain during pregnancy, history of pelvic surgery, neonatal weight, pregnancy complications, mode of delivery and second stage of labor were related to postpartum pelvic floor dysfunction. Logistic regression analysis showed that aged 35 years old and above, parity over 2 times, history of pelvic surgery, vaginal delivery, weight gain of over 15 kg during pregnancy, pregnancy complications, neonatal weight 4 kg and above, prolonged second stage of labor were influence factors for postpartum pelvic floor dysfunction (OR=3.892, 3.508, 7.862, 44.667, 12.667, 9.448, 10.444, and 23.385,P<0.05).Conclusion The incidence of postpartum pelvic floor dysfunction in parturients in our hospital is high. The monitoring and early intervention of influence factors should be emphasized and strengthened.
Objevtive To understand the incidence of postpartum depression and to analyze the influencing factors of postpartum depression, so as to provide reference for mental health care during pregnancy.Methods Totally 3 931 women 6 to 8 weeks after delivery reviewed from May 2017 to April 2018 were investigated with the Edinburgh Postpartum Depression Scale.Results (1) The incidence of postpartum depression was 5.8%, and the incidence of severe postpartum depression was 1.5%. (2) The older the mother, the lower the postpartum depression score, and the difference was statistically significant (P<0.05). There was a negative correlation between age and postpartum depression score (K=-0.066, P<0.001).There was no statistically significant difference in postpartum depression scores among women with different delivery modes and whether there were prenatal complications (P>0.05). (3) Logistic regression analysis showed that low age (OR=0.928, 95%CI: 0.897～0.960) and the occurrence of prenatal complications (OR=1.494, 95%CI: 1.093～2.042) were risk factors of postpartum depression.Conclusion For young pregnant women and/or pregnant women with complications, psychological intervention should be strengthened as soon as possible to avoid postpartum depression.
ICD-10 septicemia is classified as pathogenic bacteria. In recent years, more and more attention has been paid to systemic reactions of organisms to microorganisms and their toxins in the study of septicemia, and life-threatening organ dysfunction caused by maladjustment of host response to infection is called sepsis. The diagnosis of sepsis does not require positive blood culture results. Since ICD-10 coding of septicemia A41.9 could not accurately express the severity and disease characteristics of clinical sepsis, the national version of the coding library made a distinction with the expanded code, such as A41.900 septicemia and A41.901 sepsis. Various clinical definitions and terms are easily confused. In order to better understand the clinical terms, the definition and coding of icd-10 sepsis related diseases are summarized. At present, when the country does not use ICD-11 code, the country discusses how to accurately classify related diseases with ICD-10 and can reflect the new progress of clinical research.
